Thursday, December 30, 2010

There are a lot of misconceptions out there about this common procedure. We set the record straight on the five biggest ones.

You've heard: If you don't want to wind up in the OR, watch out for doctors whose practices have higher than average C-section rates.

The truth: Before
you judge your doctor by the number of C-sections she’s performed, you
need to know her patient population. “Some of our finest OBs have rates
that are 60 percent,” says Hope Ricciotti, M.D., associate professor of
obstetrics, gynecology, and reproductive biology at Harvard Medical
School. In many cases, that’s simply because more experienced doctors
tend to handle the kind of high-risk or multiple pregnancies that are
more likely to be delivered surgically.

You’ve heard: Celebrities always demand early C-sections.

The truth:
Indeed, says Sheryl Ross, an obstetrician in Santa Monica whose office
sees its share of boldfaced names, “A-listers are more likely to
convince their doctors that an elective C-section is more appropriate
for them.”

Most of them use their busy schedules and need for privacy as excuses. But doctors warn against having the procedure more than a week before your due date.
A University of North Carolina at Chapel Hill School of Medicine study
early this year found that babies delivered by elective C-section before
39 weeks to mothers who previously had an elective C-section had more
difficulty feeding, breathing, and required more medical assistance.

Babies
at 37 weeks are up to four times more likely than those delivered at 39
weeks to need mechanical ventilation, have low blood sugar, and require
a stay in the neonatal ICU.

You’ve heard: There’s no limit to the number of C-sections you can have.

The
truth: “The risks start rising as you have more and more Cesarean
sections,” says Ricciotti. That’s because the more scar tissue that
forms on your uterus, the more likely you’ll run into problems with
placenta implantation, bladder lacerations, bowel complications, and
infection.

“If you’re going to have one or two kids, a section is
no big deal,” says Ricciotti. But as you start having three, four, and
five kids, the risks start going way up.”

You’ve heard: You’re always better off scheduling a section when you’re past your due date than trying to induce.

The truth:
While induction before your cervix is dilated does increase the chance
that you’ll need a C-section in the end due to the possibility that the
induction will fail to cause contractions, “in general, trying an induction is the way to go
because many people can have uncomplicated vaginal deliveries with less
maternal morbidity than with a Cesarean,” says George Macones, M.D.,
chair of the department of obstetrics and gynecology at Washington
University in St. Louis School of Medicine.

A pair of twins have been born in Poland - with each child being fathered by a different man.

The mother of the twins submitted her children, a boy and a girl, to
DNA tests after filing for divorce from her husband, accusing him of
denying his paternity so as not to take financial responsibility for the
twins.

The DNA results showed that the woman's husband was the father
of the boy and the woman's boyfriend was the father of the baby girl.

This is the seventh known case in the world where a pair of twins have been born with two different fathers.

Local media reports say the mother is living with both twins and her boyfriend.

Though the top baby names in Canada this year are the solidly gendered Ethan and Olivia (according to the National Post),
Canadian studies professor Paul Stortz says that over time naming has
begun to "de-emphasize the component of gender." A peek at
BabyNames.com's most popular baby names
of 2010 reveals this may be a trend outside Canada as well.
Addison/Addyson and Bailey/Baylee were both in the top 10 for girls, and
gaining in popularity, while Riley/Rylee climbed the charts for both boys and girls. In a lot
of ways, this seems like good news — it would certainly be nice if we
didn't treat a person's gender as so obviously the most important thing
about them.

Unfortunately, gender-neutral
naming doesn't usually go both ways. Naming your daughter Charlie
supposedly makes her ballsy and can-do, but naming your son Ashley can lead to ridicule. Dr. Lisa Wade of Sociological Images has a helpful explanation:

Femininity is just for chicks. When men do feminine things, they are
debasing themselves. Masculinity is awesome and for everyone. When women
do masculine things, they're awesome. This is sexism: Masculinity
rules, femininity drools.

And then of course there's the phenomenon of women
encouraged to use gender-neutral names or initials in order to be taken
more seriously in their publishing or professional lives.

We'd like to thank the many readers who have commented and
subscribed to the blog! Hopefully, we can continue to provide useful
information throughout your pregnancy and beyond. Have a wonderful new year!

Researchers report that infants fed cow milk formula gained more weight
more quickly than infants fed protein hydrolysate formulas, which are
also known as hypoallergenic formulas meant for babies that have
problems digesting certain proteins. The proteins in the formula have
already been broken down to make digestion easier.

Sixty-four healthy infants aged 0.5 months to 7.5 months were
randomly assigned to one of the formulas for seven months. Infants were
weighed and measured once a month to assess their growth. The two groups
of infants were similar in birth weight and length at birth. Feeding
time lengths were also similar between the two groups; the infants were
also introduced to solid foods at about the same time.

Differences in the rate of weight gain
appeared as early as two months after starting the study. Although
infants fed the protein hydrolysate formula gained weight at a normal
pace, infants fed the cow's milk formula gained more weight more
quickly. Overall, the protein-hydrolysate-formula-fed infants had lower
weight-for length scores than those children given cow’s milk formula.

The researchers proposed a few theories to explain the differences in weight gain between the two groups.

“Infants may dislike the taste of protein hydrolysate formula and
consequently consume less, thereby gaining weight more slowly,” the
authors wrote. It’s also possible the higher-protein content of this
particular formula made infants feel fuller quicker, so they didn’t need
to eat as much. Researchers also question whether the amino acids in
protein hydrolysate formula may play a role in absorption and metabolism. All of these theories would require further evaluation.

Alicia Keys has penned a new song and it's inspired by her son, Egypt Daoud Dean, born on October 14. Her husband Swizz Beatz debuted the song, called Speechless, on his website.

Before the first verse kicks in, Keys says, "Im at a brand-new time in my life and a brand new feeling, and it's like this little guy, man, he takes my breath away."

The proud new mom took to her Twitter page on Monday to introduce the track.

"Speechless is a little freestyle treat 4 the holidays.
It's not a new album, not a single it's something special 4 U! My gift
to you ... a little song about my lil guy ;-) love to you....let's make
2011 incredible!!!"

Tuesday, December 28, 2010

Elton John, 62, and his partner of 17 years David Furnish, 48, welcomed a
newborn son this Christmas through a surrogate. Little Zachary Jackson
Levon Furnish-John weighed 7 pounds, 15 ounces, and was born on December
25 in California. Elton and David say they plan to protect the identity
of their surrogate and will not reveal further information about her.

Just over a year ago, the couple was heartbroken that they weren’t eligible to adopt an HIV positive infant from the Ukraine that they bonded with while on a charity visit to his orphanage. David and Elton vowed to support the
infant financially even though they couldn’t adopt the boy. (They
didn’t meet the requirements that adoptive parents be married, since
their union isn’t recognized under Ukranian adoption law, and no more
than 45 years older than the child they’re adopting.)

Back in 2001, Elton spoke about how much he adored his godchildren,
of which he has 10 including Brooklyn Beckham and Damian Hurley. He
vowed to leave his fortune to them, and it looks like he’ll have another
heir now. Congratulations to Elton and David on their new arrival!

It's normal to be scared in the
hours before delivery, but are the most common fears valid?

1. How painful will it be? Every
woman about to give birth for the first time worries about this. There are plenty of medications to relieve labor pain, from a pudendal
block to an epidural. Taking childbirth classes, such as Lamaze, might
help soothe your worries and prepare you for labor.

2. What if I'm in labor for 60 hours? Everyone
has heard the horror stories about someone being in labor for days, but
in reality, the average labor lasts 18 hours, and doctors rarely let
the process go past 20 hours. If your labor stalls, there are things
your doctor can do to augment the process, such as giving you Pitocin to
make your uterus contract, or allowing you to continue your labor in a
hot tub.

3. I'm afraid of an epidural injection gone wrong.
You've gotten past the fear of painful labor by arranging for an
epidural, but now you're terrified that a terrible complication will
occur. Relax. The risk of permanent paralysis, as well as death or a
heart attack, from an epidural falls in a range of one in 20,000 to one
in 1,000,000. Anesthetists are highly-trained doctors who perform
epidurals every day.

4. I'm afraid of losing control. Whether it's a fear of
pooping on the delivery table or a fear of cursing uncontrollably, the
possibility of not having total control over bodily functions can be
very scary -- if not completely horrifying. However, labor and delivery
nurses, obstetricians and midwives have seen and heard it all, so you
don't have to worry about shocking them. If you are really concerned
about losing bowel control, you can always opt for an enema in the early
hours of labor.

5. I don't want a C-section. You've decided you are going to go the natural childbirth route. You've even taken hypnobirthing
classes to prepare yourself. Unfortunately, when the time comes, a
complication such as the baby's heart rate becoming irregular or your
baby being too large to pass through can happen, and your doctor may
tell you he or she is going to have to perform a cesarean section. While
this may come as a disappointment, think of it as a means to an end -- a
glorious end of having a healthy baby. If you fear the cesarean
possibility, it may help for you to read up on what happens during the
procedure so that you will know what to expect if it does happen.

6. I'm afraid of tearing. This is a very common
concern among mothers-to-be, and rightly so, because tears in the
perineum (the area between your vagina and anus) are common, especially
in first-time births. Most perineal tears are superficial, and only 4
percent of women suffer serious tears. Fortunately, there are things you
can do at home before having birth that can help prevent tearing, such
as doing Kegel exercises to make the perineal muscles stronger, and
massaging your perineum to increase blood flow and the elasticity of the
muscles.

7. Will I need an episiotomy? Twenty
years ago, an episiotomy was a routine procedure performed before labor
to prevent the aforementioned tearing. However, studies have shown
episiotomies really aren't necessary, and the American Congress of
Obstetricians and Gynecologists has recommended against the procedure.

8. What if I don't make it to the hospital in time?
This seems to be one incident that really only happens in the movies
and on television, but it is possible. In only less than one percent of
births does a pregnant woman suddenly feel the urge to push without
labor symptoms or contractions. However, it can happen, especially if
you have had a previous quick labor. If you do find yourself in this
situation, the American College of Nurse-Midwives has a document, A Guide to Emergency Preparedness for Childbirth that gives step-by-step instructions on what to do in case of an emergency.

9. I'm afraid the umbilical cord will strangle my baby.
While this fear conjures up a frightening image, could it really
happen? The cord can end up around your baby's neck during delivery, but
it is important to remember that he or she is not breathing through his
or her mouth yet. You are still breathing for your baby. Even if the
cord gets stretched, there are mechanisms in place that allow them to
continue working properly. If your baby is born with his or her cord
around the neck, all the doctor needs to do is untangle it after birth
before clamping it.

10. I'm afraid I will die. This fear goes through the
mind of every mom-to-be because, although the risk is low (13.3 deaths
per 100,000 live births in the U.S. in 2006), it's still a remote
possibility, especially if you have a cesarean section. However, taking
childbirth classes, as well as taking a tour of the labor and delivery
department of your hospital, may ease your mind. Talking to your
obstetrician about this worry will also help your state of mind.

Infants at age 3 months who had newborn blood levels of 25-hydroxyvitamin D - a measurement of vitamin D - below 25 nanomoles per liter (nmol/L) were twice as likely to
develop respiratory infections as infants who had levels at 75 nmol/L or
higher, according to an international study.

That finding is based on umbilical cord blood samples taken from
more than 900 infants to measure blood vitamin D levels. Earlier
research has suggested that mothers who have higher levels of vitamin D
in their blood during pregnancy are more likely to give birth to infants who are at a lower risk for wheezing.

Investigators led by Carlos Camargo, MD, DrPH, an associate
professor of medicine and epidemiology at Harvard Medical School,
examined whether vitamin D levels in the infants’ umbilical cord blood
were associated with risk for respiratory infections, wheezing, or
asthma.

Camargo and researchers from New Zealand analyzed data from the
New Zealand Asthma and Allergy Cohort Study, which followed more than
1,000 children in the cities of Wellington and Christchurch.
Umbilical cord samples were available from 922 infants. Most
infants were born to term at 40 weeks, and the average was about 3.6
kilograms or about 7 pounds and 9 ounces.

Mothers were also frequently interviewed about their children’s
history of asthma, wheezing, and respiratory infection from age 3 months
until the children turned 5 years old. Very few children in the study
took vitamin supplements; their vitamin D status came mostly from sunlight exposure.

Researchers found that:

About 20% of infants had 25-hydroxyvitamin D levels below 25 nmol/L, which is considered below normal vitamin D levels.

The average level of 25-hydroxyvitamin D was 44 nmol/L, which was still considered low.

Lower vitamin D levels were more common among children born in
the winter, children of lower socioeconomic status, children who had
family histories of asthma and smoking and who had been exposed to secondhand smoke at an early age.

Low vitamin D levels were associated with wheezing and
respiratory infection, but not associated with being diagnosed with
asthma. The findings do not establish cause and effect.

The study is published in the January issue of Pediatrics, a journal of the American Academy of Pediatrics.

Vitamin D, found abundantly in fortified dairy products such as
milk and cheese, is known for helping children build strong bones, but
it can also help bolster the immune system, researchers note. Vitamin D
is also produced by the body when exposed to sunlight.

"Our data suggest that the association between vitamin D and
wheezing, which can be a symptom of many respiratory diseases and not
just asthma, is largely due to respiratory infections," Camargo says in a
news release. "There's a likely difference here between what causes
asthma and what causes existing asthma to get worse. Since respiratory
infections are the most common cause of asthma
exacerbations, vitamin D supplements may help to prevent those events,
particularly during the fall and winter, when vitamin D levels decline
and exacerbations are more common. That idea needs to be tested in a
randomized clinical trial, which we hope to do next year."

Very young children - even infants - can realize that
other people see the world differently than they do, a new study
suggests. And, they seem to make this realization automatically, without
deliberate effort, the authors report in journal Science.

The ability to infer others' intentions and beliefs, often
known as "theory of mind," is an essential part of social interactions
and may have been a central condition for the evolution of cooperative
human societies. Until a few years ago, it was generally accepted that
theory of mind abilities didn’t arise until children were three or four
years old. Since then, a flurry of studies using a variety of methods
has suggested that much younger humans might in fact possess this
capacity.

Ágnes Melinda Kovács and colleagues have devised a new approach to
this question and applied it to both adults and to seven-month-old
infants. The experiments involved showing the test subject a series of
animated videos in which a ball first rolls behind a small wall, and
then either stays there, rolls out of view, or rolls away and comes
back.

A cartoon character observes different intervals of this process. At
the end of each video, the researchers measured how long it took the
test subjects to detect the ball. (For the babies, the researchers
inferred this based on how long it took the infants to look away from
the screen.)

Both the adults’ and infants’
reaction times were faster when the cartoon character’s “belief” about
the ball’s location matched the ball’s actual whereabouts. This was the
case even when the cartoon character had left the screen by the end of
the video. Kovács and colleagues conclude that from seven months on we
automatically perceive other people’s points of view, and even when
these other people are no longer present, we still remember their
beliefs as alternative representations of the world.